Elavil - Comprehensive Usage Guide: instructions, indications, composition, side effects

• Active Ingredient: Amitriptyline hydrochloride
• Excipients: May include lactose, colloidal silicon dioxide, magnesium stearate, and other inactive ingredients depending on the formulation.

• Tablets: Available in various strengths, including 10 mg, 25 mg, 50 mg, 75 mg, and 100 mg tablets.

Elavil belongs to the pharmacological group of tricyclic antidepressants (TCAs) (ATC code: N06AA09).

• Pharmacodynamics: Amitriptyline exerts its antidepressant effects by inhibiting the reuptake of serotonin and norepinephrine in the synaptic cleft, thereby potentiating their neurotransmission in the central nervous system (CNS). Additionally, it has anticholinergic, antihistaminic, and alpha-adrenergic blocking properties.
• Pharmacokinetics: Amitriptyline is well-absorbed after oral administration, with peak plasma concentrations achieved within 2 to 12 hours. It undergoes hepatic metabolism via the cytochrome P450 enzyme system (primarily CYP2D6) and is excreted mainly in the urine.

Elavil is indicated for the treatment of:

• Major depressive disorder (MDD)
• Neuropathic pain
• Migraine prophylaxis
• Insomnia (off-label use)

Elavil is contraindicated in individuals with:

• Hypersensitivity to amitriptyline or any component of the formulation
• Recent myocardial infarction
• Concomitant use of monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy
• Acute recovery phase following myocardial infarction

Amitriptyline may interact with other medications, including:

• MAOIs, SSRIs, SNRIs, tricyclic antidepressants, and other serotonergic drugs, increasing the risk of serotonin syndrome
• Drugs that inhibit CYP2D6 enzymes, potentially increasing amitriptyline levels and toxicity
• CNS depressants, alcohol, and anticholinergic drugs, potentiating sedation and anticholinergic effects

• Elavil should be taken orally once daily at bedtime, as directed by a healthcare provider.
• The initial dosage for depression is typically 25 mg/day, gradually titrated to a therapeutic dose of 150-300 mg/day based on patient response and tolerability.
• For neuropathic pain and migraine prophylaxis, lower initial doses may be used, with gradual titration to an effective dose.

• Elavil should be used with caution during pregnancy, especially during the third trimester, and only if the potential benefits outweigh the potential risks to the fetus.
• Amitriptyline is excreted in breast milk, and breastfeeding is not recommended during Elavil treatment due to the potential risk to the infant.

• Dosage adjustments may be necessary in patients with hepatic impairment or renal impairment to prevent drug accumulation and minimize the risk of adverse effects.
• Elderly patients may require lower initial doses and slower titration due to age-related changes in drug metabolism.

In case of overdose, supportive measures should be initiated, and medical attention should be sought immediately. Symptoms of amitriptyline overdose may include drowsiness, coma, convulsions, and cardiac arrhythmias.

Common side effects of Elavil may include:

• Sedation
• Dry mouth
• Constipation
• Blurred vision
• Urinary retention
• Weight gain